Pharm 3 quiz Flashcards
c diff symptoms (C, it’s watery)
watery diarrhea, abdominal pain, fever. **Gas pain. can only be cleaned with bleach.
c diff cause
antibiotics disrupt normal gut microflora causing an overgrowth of c. diff
vaginitis causes
tetracycline, normal vaginal microflora is disrupted and overgrowth. Superinfection.
treatment for crystalluria
increase water to 2000 to 3000 mL/water in 24 hrs. IV fluids. Check breath sound before giving water.
crystalluria is caused by
sulfonamides
cillin allergic reactions (and what percentage) (penicillin is a ute that has hives)
0.7 - 4%. Urticaria (hives), pruritus, angioedema (swelling underneath the skin) anaphyalactic .0004% rare
cross-sensitivity to Cephalosporin
potential cross-sensitivity to penicillin if true allergy exists.
Cephalosporin drug interactions (NOT penicillin - this is interactions) and take with what?
alcohol, antiacids, iron, probenecid, contraceptives. (take with food)
tetracycline avoid
milk and cheese.
tetracycline s/e
teeth and bones, photosensitivity, vaginal candidiasis, Gastric upset, Enterocolitis, Maculopapular rash, Other effects, pass through milk, tetrogenic.
aminoglycosides s/e (amine is bad for my ear)
nephrotoxicity and ototoxicity
quinolone s/e (quinn not a QT going to the grave, she has tendonitis)
prolonged QTs, bacterial overgrowth, dysrythmias, tendon rupture, tendonitis, neuropathy, seizures, myasthenia gravis. Watch for gait.
quinolone drug interactions (quin needs tums)
antacids, calcium, mg, iron, zinc. Take 1 hour before or after.
Xofluza - name and for what? (xo in A and B bali)
baloxavir marboxil
xofluza - when to take and what ages? (xiola is 12 yrs old)
Should be taken only in the first 2 days
after symptoms such as fever, aches &
sniffles appear
For use only in those aged 12 or more
adherence
collaboration and active role btwn patient and provider
antiretroviral
antiviral drugs that work against retroviruses like HIV
assembly
The stage of replication during which all the structural components come together at one site in the cell and the basic structure of the virus particle is formed.
budding
Budding enables viruses to exit the host cell and is mostly used by enveloped viruses.
The immature virus pushes out of the infected cell in a process called “budding.”
CCR5 antagonists
They mask the CCR5 binding site so the virus doesn’t see it and can’t enter.
bind to the CCR5 chemokine coreceptor on host cells, inducing a conformational change that impedes CCR5 interaction with HIV gp120, thereby preventing HIV entry into host cells.
CD4+T - what do they do?
The CD4+T cells carry out multiple functions, ranging from activation of the cells of the innate immune system, B-lymphocytes, cytotoxic T cells, as well as nonimmune cells, and also play critical role in the suppression of immune reaction
entry inhibitors
Entry inhibitors work by attaching themselves to proteins on the surface of CD4 cells or proteins on the surface of HIV. In order for HIV to bind to CD4 cells, the proteins on HIV’s outer coat must bind to the proteins on the surface of CD4 cells. Entry inhibitors prevent this from happening.
highly active antiretroviral therapy
(HAART)
combo of anti-retroviral drug cocktails - standard for HIV. control viral load, delaying or preventing the onset of symptoms or progression to AIDS, thereby prolonging survival in people infected with HIV.
Reverse transcriptase
RNA is turned into DNA.
DNA polymerase enzyme that transcribes single-stranded RNA into DNA. reverse of usual process. This is what HIV does.
integrase (integrate virus)
enzyme that promotes viral DNA into host DNA
integrase inhibitors
antiretroviral drug designed to block the action of integrase
non nucleoside analogues used to treat what? (no nukes for Art)
used to treat HIV as part of antiretroviral therapy (ART). ARVs interfere with the ability of a virus to multiply or reproduce.
nucleoside analogues
mimic endogenous nucleosides, exploiting cellular metabolism and becoming incorporated into both DNA and RNA. This property makes nucleoside analogues effective at inhibiting viral replication
postexposure prophylaxis (PEP) - how quickly should you take it and for how long? And what treatment? (Ralt is true to pep)
means taking medicine to prevent HIV after a possible exposure. PEP should be used only in emergency situations and must be started within 72 hours - for 28 days - after a recent possible exposure to HIV.
protease and HAART - (always has on NRTI)
a large group of enzymes that catalyze the hydrolysis of peptide bonds in proteins and polypeptides.
two or three NRTIs; two NRTIs plus one or two protease inhibitors; or a NRTI plus a NNRTI with one or two protease inhibitors
protease inhibitors (Tease HIV, tease hump)
It is one of the 5 classes of antiretroviral drugs. It works by inhibiting the HIV and protease retroviral enzymes that cleaves protein. . inhibit the cleavage of the polyprotein into functional proteins are called protease inhibitors. Protease is a protein-based enzyme that normally breaks the polyprotein into functional proteins, so blocking, or inhibiting, protease prevents this essential step of viral reproduction
reverse transcriptase inhibitors
block reverse transcriptase (an HIV enzyme). HIV uses reverse transcriptase to convert its RNA into DNA (reverse transcription). Blocking reverse transcriptase and reverse transcription prevents HIV from replicating.
amantadine (A for amantadine. aman symmetrical)
Symmetrel®- influenza A, onset within 48 hours. can be used in children, but cannot use in children less than 12 months.
rimantadine (A rim is good for kids)
Flumadine - influenza A -can be used in children.
zanamivir, oseltamivir (A Bee in Zanzebar)
Oseltamivir (Tamiflu®) and Zanamivir (Relenza®) - influenza A and B
amantadine best practices (Aman brushes her teeth..) narrow or wide?
Narrow. good oral care, causes dry mouth, monitor BP, ortho hypo, use large vein to avoid irritation. not for patients w/ exzema.
ramantadine best practices
same an amantadine but less side effects, less dizziness. can be used in children.
zanamivir, oseltamivir best practices - how fast to take it and what does it do? (zanzebar was my bud for 2 days)
stops budding. n/v. treatment needs to begin w/in 2 days.
CMV treatment (gang of cmv)
Ganciclovir (Cytovene®) and citofovir , foscarnet. Ganciclovir - Ophthalmic form surgically implanted
CMV (CMV not just HIV)
inflammation of retina can cause blindness. HHV 5 herpes.
allergic reaction
vancomycin - + or -? And treats what? (in the van w/ portable)
fights gram positive. treats c diff and staph.
MRSA treatment of choice (MRSA LOVES van)
vancomycin
vancomycin s/e (red man has bad ears)
nephrotoxicity and ototoxicity. red man syndrome and severe hypotension (infused too rapidly)
how fast to infuse vancomycin?
no faster than 60 minutes
vancomycin peak
18 - 50 mcg/mL
vancomycin trough (van is low at 10-20)
10 - 20 mcg/mL - only trough levels are monitored
vancomycin peak time
1 hour
vancomycin blood draws when?
immediately before next dose - you have 30 min leeway
best antibiotic for pneumonia gram + infection (ceph is best for +)
1st generation cephalosporin
cephalosporin 1st generation (the 1st generation is always positive)
Good gram-positive coverage Poor gram-negative coverage Parenteral and PO forms
Examples
cefadroxil (Duricef®, Ultracef®) cephradine (Velosef®)
cefazolin
cephalexin (Keflex®)
cephalosporins 1st generation used for (1st generation good at prevention)
Used for surgical prophylaxis, and for susceptible staphylococcal infections
cefazolin (Ancef® and Kefzol®): IV or IM cephalexin (Keflex ®): PO
cephalosporin 2nd generation (2nd generation only notable for anaerobic)
only generation w/ anaerobic coverage . Good gram-positive coverage
Better gram-negative coverage than first generation Examples:
cefaclor (Ceclor ®) cefprozil (Cefzil ®) cefoxitin (Mefoxin ®) cefuroxime (Zinacef ®) cefotetan (Cefotan) ®
ceph 2nd generation cefoxitin (the 2nd fox in my stomach)
abdominal and colorectal surgeries. kills anaerobes
ceph 2nd generation - cefuroxime (2nd fur prevents cold)
surgical prophylaxis, does not kill anaerobes
cephalosporins 3rd generation (3rd generation is def negative)
Most potent group against gram-negative bacteria Less active against gram-positive bacteria
Examples
cefotaxime (Claforan®) ceftazidime (Fortaz®) cefdinir (Omnicef®) ceftizoxime (Cefizox®) ceftriaxone (Rocephin®)
cephalo 3rd generation - ceftriaxone (3rd generation tria can get into your brain)
elimination is hepatic. easily passes meninges and diffuses into CSF to treat CNS infections
cephalo 3rd generation - ceftazidime (taz is negative spaz, but he likes pseudos)
excellent gram negative, used for difficult to treat, like pseudomonas. excellent spectrum coverage. resistance is limiting it’s usefullness.
cephalosporins 4th generation (4th generation is everywhere, and esp positive)
Broader spectrum of antibacterial activity than third generation, especially against gram-positive bacteria
Uncomplicated and complicated UTI cefepime (Maxipime®)
cephalosporin 5th generation - ceftaroline - only thing 5th generation ever did…
ceftaroline (Teflaro®)
Broader spectrum of antibacterial activity Effective against a wide variety of organisms
only cephalosprin approved for MRSA
cephalosporins adverse effects - inteacts with just one thing…
cross-sensitivity with penicillin if true allergy exists. n/v. diarrhea.
Retrovirus
uses RNA for genetic material
window period HIV
6 wks to 3 months
during window period - and is test + or - ?
No symptoms or signs of illness
HIV test is negative during Window Period
Virus is multiplying rapidly - viral load is high
person is VERY infectious
primary goal HIV window period
Primary Goal= viral load < 50 Copies/mL- considered undetectable
seroconversion - and when does it happen?
point at which HIV test becomes positive. Happens about 3 months after infection.
HIV asymptomatic period - think
Duration variable: < 1 year to > 15 years. The CD4 count is above 500 cells/mL
CD4 below 200
CD4 below2 00 = palative Treatment
CDC levels for CD4-T cells
500 - 1600: normal
200 - 500: beginning of HIV illness
< 200: AIDS
infection rate for practitioner to contract HIV and for 28 days
Pooled analysis of prospective studies on health care workers with occupational exposures suggests risk is approximately 0.3% (95% CI, 0.2% - 0.5%)1 within 72 hours of exposure for 28 DAYS- last 2 weeks kills any that might have slipped into a cell
Nevirapine classification (Nev is NN-ervring but not competitive)
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Nevirapine s/e - hiv (Nev with an itchy liver)
rash-fever-n/HA- abn liver function. risk is greater in first 18 wks of treatment.
Fuzeon (and used with what?)
prevents vial cell attaching to cells. always used with other HIV drugs.
fuzeon - major side effect - hiv
SQ - everyone has an injection site irritation. can have allergic reactions, pneumonia.
Efavirenz s/e - hiv (fav bridge)
mental health - suicide, liver and skin reactions.
What is the rationale for HIV/AIDS pts to understand and know each med they are taking and why it will not cure them but keep their viral loads manageable
need to suppress viral load.
goals for HIV therapy
A. The viral load is undetectable.
B. The CD4+ count is as low as possible. C. Secondary infection does not occur. D. Medication regimen is adhered to.
Can antiviral drugs kill both healthy and cancer cells
Yes. often harms healthy cells bc they can only inhibit development and some of the proteins overlap with healthy cells. can kill herpes that leads to cancer - Kaposi - check this
Antineoplastic meds - what is important? (cancer needs water)
hydration important to prevent nephrotoxicity
pregnant women can’t take which anti-viral? (pregnant women can’t have viral ribs)
Ribavirin (Virazole®) - teratogenic -
best med for herpes simplex? (think)
acylcovir. synthetic necleoside analog. blocks cellular %. used to suppress replication of HSV-1, HSV-2, VZV.
HIV transmission - how?
sexualactivity,intravenousdruguse, perinatally from mother to child
HSV1 treatment - can it cure?
can’t cure but can speed up remission and reduce painful symptoms
What medication is used for Ocular implant and how susceptible of contracting is it?
Ganciclovir (Cytovene) - HIV and transplant
pt education for cancer drugs - physical, oral care, and diet - avoid what foods?
Comprehensive Physical assessment, Oral care education, Dietary education- to avoid spicy-acidic-alcohol & tobacco
PI - primary immunodeficiencies (it’s primarily genetics)
Primary immunodeficiencies are the result of genetic defects, and secondary immunodeficiencies are caused by environmental factors, such as HIV/AIDS or malnutrition.
What medication is used for Ocular implant and how susceptible of contracting is it?
Rationale use of Hormone Therapy
hormones increase cancer
Targeted Drug Therapy
danger of giving an Vinca alkaloid drug intrathecally (Vin is fatal)
vincristine is nearly always fatal and associated with an irreversible, painful ascending paralysis.
health care associated infections also known as (no illiana in health care)
nosocomial and iatrogenic
empiric, definitive, and prophylactic
empric - before culture has been identified.
proph - prevents infection, abdominal surgery.
bacteriostatic
inhibits growth rather than killing immediately
sulfas + or -?
+ and -
pneymocystis jirovecii pneumonia - what drug? (jovi sulfur face)
sulfa
Penicillinase
Penicillinase-resistant penicillins? a type of penicillin?
bacterial strain exposed to penicillin may produce an extracellular enzyme called penicillinase which leaves the bacterial cell and degrades the penicillin around it
penicillin - how does it work? and + or -?
enter via cell wall, bind to penicillin-protein, cell wall distrupted. gram +
cephalsporins - killer ceph
bacteracidal
carbapenems - what for? (carbs are complicated connective tissue)
Reserved for complicated body cavity and connective
tissue infections in acutely ill hospitalized patients.
tetracycline - positive or neg? (tet in the hot tub with sulfa)
both.
superinfection from which drug?
tetra, aminoglycoside
what to take with all antibiotics?
at least 6 to 8 ounces of water
sulfa take with how much water over 24 hrs?
Take with 2000 to 3000 mL
of fluid/24 hr
how long to monitor pt for penicillin reaction
at least 30 min
aminoglycosides - + or -? And kills what?
kill gram -. some +, but mostly -.
how to administer aminoglycosides?
parenterally, only one is given orally.
linzoid - don’t take with…(linz and tyrine don’t get along, he gives her SS)
Linz is just an antibiotic. tyramine-containing foods, seratonin syndrome
what to take for protozoa infection? (your old friend)
metronidazole
nitrofurantoin (Macrodantin®) good for…(my bladder is on nitro)
UTI, Drug concentrates in the urine
Ledipasvir/Sofosbuvir (Harvoni) Hep C - what issue? (lead sofas cost a lot for hep c patients)
Can be Cost Prohibitive
anti-retroviruses - what to monitor for? (anti-retroviruses like opportunities)
opportunistic diseases
HAART typical results
Decreased viral load to undetectable levels (<50
Copies/mL)
Improved CD4+ T cell count (>500/mm3)
protease inhibitors suffix (tease tel aviv) and used for WHAT?
protease enzyme that cleaves protein - opinavir/ritonavir (Kaletra®), atazanavir (Reyataz®),
fosamprenavir (Lexiva®), etc.
Cancerous cells do not have
Growth control mechanisms
Positive physiologic function
cell-cycle specific drugs used for what?
drugs act during multiple phases of the cell cycle - anti-tumor
cell-cycle non-specific drugs
Cytotoxic during any cell-cycle stage
infiltration (the meds infiltrated my tissue)
When a non - vesicant solution or medication is introduced to the tissue surrounding the IV catheter
Methotrexate (cancer) is also used to treat (meth for cancer, psor, and arthritis)
severe cases of psoriasis and rheumatoid arthritis
antimetabolites adverse affects (anti- feet)
palmar-plantar - hand foot, n/v myleosuppression, hair loss, tumor lysis
mitotic inhibitors (cancer) adverse effects (mite you be extravagant)
Extravasation
cancer drugs - monitor for (cancer oj)
stomatitis, n/v, diarrhea,
alkylating drugs (cancer) - dose-limiting bc (alky bones)
Nausea and vomiting, myelosuppression
cytotoxic antibiotics (cancer) (cancer toxicity always inserts itself)
Act by inserting, resulting in blockade of DNA synthesis
daunorubicin (cytotoxic) adverse effects (dan is toxic to my heart)
Heart failure
Beta-lactamases are (the mase is resistant)
enzymes produced by bacteria that provide multi-resistance to beta-lactam antibiotics such as penicillins, cephalosporin
sulfas - bacteriostatic or bactericidal? (the sulfur gave me static)
static
if you have a UTI, what class of drug is helpful?
sulfa
beta-lactams include what? (take milk with carbs and spores with your penicillin)
(1) penicillins, (2) cephalosporins, (3) carbapenems, and (4) monobactams.
Most natural penicillins have little, if any, ability to kill
gram negative bacteria.
ceftaroline only available in what form? (taroline injects)
injectable
RSV for infants/children medication (infants in RVs)
palivizumab and ribavirin
macrolides - static or cidal? (glide into static)
static, but cidal in high doses
cephalosporins - cidal or static? (neosporin kills the cells)
cidal - cell wall.
cephalosporins - cidal or static?
cidal - cell wall.b
broadest action of any antibiotic
Carbapenems
macrolides end in what? (throw mice and glide)
azithromycin, clarithromycin, dirithromycin, and erythromycin.
complicated connective tissue infections in acutely ill patients - use what antibiotics?
Carbapenems
When patients become infected with CRE, there are only
two known antibiotics that can be used: (cre likes tigers with colostomies)
tigecycline and colistimethate
how are viruses transmitted?
inhalation, injection, ingestion, and via placenta.
cell-mediated are specific or non-specific?
non-specific - just T cells, not B cells
herpes simplex 3 (3 for you)
chickenpox and shingles
cancer pre-meds (pre meds are the ABCs BCD - N)
Use of premedication 30-60 min benadryl, tylenol,Corticosteroids, such as dexamethasone, n/v drugs
cancer risk of infection due to….(neutro cancer)
low Neutrophils, To prevent infection pt/family/staff to protect pt should perform good Hand Hygiene
cancer - when to report fever?
Report fever of 100.5/38.1 immediately, Hydration is key to preventing hemorrhagic cystitis
cancer - fruits and veggies?
Wash fruits/vegi’s d/t they can have germs to infect pt on them, Avoid recently vaccinated people, they are not yet fully covered
med error
Nurses are the Sharp end of the tool in giving meds, however the MD, Pharmacologist, are also part of the process. But we are the last to protect our patients. However, if a RN doesn’t complete the 9 Rights, then it would be an RN med error
foscarnate - forget this one
for leaching bones ? used for CMV but not preferred.
zidovudine (Retrovir®)
rock baby from A to Z
carcinomas are where in the body? (carcinoma in my mouth)
epithelial tissue or lining of organs
sarcoma (c for connect)
connective tissue
leukemia
blood and bone
Paraneoplastic Syndromes (pair of ovaries hair gut and bones)
hair, gut, ovaries and bone - fastest growing what chemo attacks (abnormal response to tumor, weakness)
Antineoplastic drugs - Divided into two groups based on where in the cellular life cycle they work -
Cell cycle–nonspecific (CCNS)
Cell cycle–specific (CCS)
non specific cancer meds
kills cells no matter what phase it’s in
chemo drugs have a wide or narrow therapeutic index?
Drugs have a narrow therapeutic index
Nadir
my dear we hit rock bottom
folate
need folate prenatal - antimetabolite - methotrexate (MTX), blocks it from absorbing the folate
antimetabolites - (I can’t metabolize folic acid)
Folic acid antagonism
Interferes with the use of folic acid
As a result, DNA is not produced, and the cell dies
antimetabolites used for (exactly) (metabolize John’s leukemia)
Acute and chronic lymphocytic leukemias
Leukemias (several types)
Colon, rectal, breast, stomach, lung, pancreatic cancers
what causes Tumor lysis syndrome? And it produces (metabolites cause lice and feet)
antimetabolites. a lot of uric acid
leucovorin (luke folate to the rescue from meth)
luke to the rescue - reduce the bone marrow suppression caused by the methotrexate. gives you more folate acid and prevents healthy cells from dying.
mitotic adverse affects (mite you be extravagant with convulsions)
Liver, kidney, lung toxicities
* Convulsions
* Extravasation
The nurse identifies which of the following as the most significant neurotoxin of the cytotoxic drug class?
vincristine (Vincasar PFS)
Topoisomerase 1 Inhibitors for…(Topher is small)
Ovarian and colorectal cancer Small cell lung cancer
Other tumors
Topoisomerase 1 Inhibitors - side effect occurs when? (toph w/ tummy troubles)
Irinotecan causes cholinergic diarrhea (delayed,
occurring 2 to 10 days after dosage)
nuetrophilic (what is the number)
less than 500
rbc anemic - platelets (tu has less than 1000 in b of a)
platelets - less than 1000 risk for bleeding
belomycin - antibiotic - what side effect? (blip in lungs)
can cause pulmonary fibrosis.
cell specific (cancer) kill fast or slow cells?
fast-dividing cells
cell (cancer) non-specific kills fast or slow cells? (non-specific is really slow)
the slow-dividing cells
classes of antibiotics (Antibotics can protect the queen’s men and servants)
Sulfonamides
Penicillins
Cephalosporins
Macrolides
Quinolones
Aminoglycosides
Tetracyclines
antibotics work how (antibiotics work by building a wall…)
cell wall, protein, DNA replication, metabolite
ex of sulfas (septra for sulfa)
bactrim and septra
sulfas cause what side effects? (sulfur thumbs)
anemia, agranulocytosis (low granulocytes - WBCs), thrombocytopenia (low platelets)
penicillin interactions (my pen is at war with NSAID)
NSAIDs
Oral contraceptives Warfarin
which one causes thrush? (ceph is thrushy)
cephalosporin
macrolides for what diseases? (glide into adolescence)
strep, STDs
what age can kids use tetra?
not younger than 8 or pregnant women
what treats SIADH? (my SIADH is dem cyclone)
Demeclocycline - a tetra
which can’t you take with protein-bound drugs? (don’t go on slide w/ pb and j)
macrolides bc they are protein-bound
which can’t you take with protein-bound drugs? (peanut butter doesn’t glide)
macrolides bc they are protein-bound
which is usually given IV? (Amine needs an IV)
aminoglycocides
May cause fatal hepatotoxicity (cars kill liver)
nitro
CRE
CRE refers to bacteria that possess an enzyme, carbapene- mase, which renders the organism resistant to all carbape- nem antibiotics as well as beta-lactam antibiotics
how to treat ESBL? (extended spectrum beta-lactamase) (carbs when watching ESPN)
carbapenems or sometimes quinolones
gentimicin is a what? (Amine is not at all gentle)
aminoglycoside
how do aminoglycosides work? (The only way amine can work is by clinging to others’ ribs)
bind to ribosomes
which are used for synergestic effect? (there is synergy btwn amine, milk, and vans)
aminos and beta-lactams or vancomycin
HIV drugs - names (Ralt wearing fuzzy)
fuzeon and raltegravir
Ganciclovir (don’t let the gang touch your skin)
bone marrow suppression; don’t get on skin!
Bedaquiline - (in bed with TB)
TB
how do sulfas work? (sulfa works the spinach)
Prevent synthesis of folic acid required for synthesis of purines and nucleic acid. Only affect organisms that synthesize their own folic acid.
carbapenems - broad or narrow?
broadest to date
amantedine s/e (A does not have insomnia)
s/e insomnia nervousness
what does amine kill? (amine killed mona and coli)
kills pseudomonas, e. coli.
carbpenems adverse effect (too many carbs cause seizures)
can cause seizures
there are currently two broad classes of cell cycle–nonspecific cancer drugs: (alkys are toxic and not specific)
(1) alkylating drugs and
(2) cytotoxic antibiotics.
alkylating drugs (aklys love mustard)
classic alkylators (the nitrogen mustards); (2) nitrosoureas, which have a different chemical structure than the nitrogen mustards but also work by alkylation; and (3) miscellaneous alkylators,
cytotoxic antibiotics consist of (cytoxic is actually natural)
natural substances produced by the mold Streptomyces as well as semisynthetic substances
What is student RN actions for suspected allergic medication reaction
alert RN charge nurse
provide 02
monitor RR
be ready to perform cpr
monitor VS
prepare epinephrine
Vinca (vin can only do IV)
only IV
Targeted drug therapy (target my mono)
Targeted drug therapy uses drugs that recognize a specific molecule involved in the growth of cancer cells, while mostly sparing healthy cells. One example of such targeted therapy is the newer class of cancer drugs known as monoclonal antibodies.
bleomycin (cytotoxic) adverse effects (bleo toxic my lungs w/ pneumonia)
Pulmonary fibrosis and pneumonitis
doxorubicin side effect (cytotoxin) (dox in my heart)
Cardiomyopathy is associated with large amounts of doxorubicin
protease inhibitors are for what virus? (don’t tease HIV)
HIV
daunorubicin is what type of drug? (dan needs chemo)
chemo
antimetabolites treat what? (can’t metabolize cancer)
cancer
mitotic used for what?
cancer, stops mitosis
2 species that cause TB
bovis and tuberculosis (bovis less common)
TB grows where in the body?
lungs - it needs 02, ends of bones, and brain
what animals carry TB?
humans, birds, and cattle
what precaution w/ TB?
airborne
INH
primary antitubercular drug - can cause liver problems
aminoglicosides end in what? (amine is less than a macrolide)
mycin
alkylating drugs are for what? (alkys beat cancer)
cancer
DNA USUALLY…
turns into RNA, then protein. Reverse transcriptase is the opposite.
CMV is what?
cytomegalovirus -
vancomyin - static or cidal? (vans kill)
cidal
cephalo 3rd generation - treatment for what? (Don is a 3rd gen)
one of only a few meningitis treatments
problem w/ cephalo 3rd generation
resistance is limiting its usefulness
protease inhibitors - s/e (don’t tease the hump)
lipodystrophy - hump at posterior of neck and skinny face.
type 2 diabetes.
cancer patients avoid which ppl?
recently vaccinated - they aren’t safe yet
hormonal drugs for women (and ana hormone)
tamoxifen, anastrozole, megestrol
hormone drugs for men (men amide for women)
estramustine, bicalutamide (any amide)
lock and key mechanism- target therapy (cancer drugs)
targeting of one molecule on surface and involved with growth of tumor or enzyme in cell. causes apoptosis
examples of lock and key (monoclonal tick in lock - tick tock)
monoclonal and tki - tyrosine kinase inhibitors
aminogylcoside treat what? (amine is a pain in my abdomen but good for my heart)
severe infections of the abdomen and urinary tract, as well as bacteremia and endocarditis. They are also used for prophylaxis, especially against endocarditis.
Paraneoplastic Syndromes
symptoms not directly connected to spread of cancer.
Cachexia (most common, wasting)
Fatigue, fever, weight loss
Others
Extravasation is when a (a little extra)
a vesicant solution or medication is introduced to the tissue surrounding the IV catheter
cold compress when? (cold for DNA)
CT, phelbitis and most DNA binding vesicants
warm compress when? (warm w/out DNA)
non DNA binding vesicants
antimetabolites purine - what side effect? (pure lysing)
tumor lysis
treatment for karposi (Mite you be karposi?)
mitotic
most significant neurotoxin
vincristine
chemo during pregnancy?
2nd and 3rd trimester less risk
montior for what if WBC is low?
fever = infection
alkylating drugs work how? (aklys work by not reproducing)
by preventing cancer cells from reproducing
Alkylating Drugs need what? (Alkys need a buddy)
Used in combination with other drugs
how do Cytotoxic Antibiotics work? (cytotoxic inserts around the clock)
active in all phases of cycle. Act by intercalation, resulting in blockade of DNA synthesis
dexrazoxane (dex decreases dox)
decrease toxicity of doxorubicin (cytotoxin)
Alkylating drugs esp. need
water
Cytotoxic antibiotics - watch for…(bleo toxic in my lungs)
pulmonary fibrosis
Community-associated
infections
hasn’t been hospitalized in the past year
disinfectant and antiseptic
disinfectant kills
gram + (gram positive glides with penicillin)
penicillin and macrolides
gram - (amine NO and quin are negative)
aminoglycosides, quinalones
gram + and - (STNCC in hot tub)
tetra, ceph, sulfas, carbs, nitros
Penicillins do or do not kill other cells in the body
not
tetracyline - static or cidal? (tetris gives me static)
static
reduces tetra effectiveness? (tetra is reduced to milk, tums, and iron)
Dairy products, antacids, and iron
salts reduce oral absorption of tetracycline
assess what before giving sulfas? (RBCs in hot tub)
RBCs
aminoglycocides usually not given what route?
PO
which has a thin cell wall?
gram negative are pink bc the wall is thin and stain leaks out
how does amine work? (Amine zaps my energy and protein)
kills proteins
how do cephalosporins works? (Ceph works for the Cell wall)
kill cell wall
tetracycline works how? (tetra doesn’t work for protein)
inhibits protein synthesis
how does quin work? (quin has bad DNA)
inhibits DNA
quin ends in (quin has a flock of oxen)
floxacin
In leukemia…(luke is abnormal)
In leukemia, a cancer of the blood, the bone marrow makes abnormal white blood cells
In aplastic anemia…
the bone marrow doesn’t make red blood cell
colony-stimulating factors (cancer)
Granulocyte
colony-stimulating factor (G-CSF) stimulates the production of
neutrophils.
There are two brands of G-CSFs (cancer) - Granulocyte colony-stimulating factors
Neupogen® (filgrastim) and
Neulasta® (pegfilgrastim). The only difference between these drugs is that Neulasta is given less
often.
Used in cancer chemotherapy
and CKD induced anemia
Erythropoietin - and the drugs are Procrit®, Epogen®, and Aranesp®. Very dangerous - heart problems.
Granulocyte colony-stimulating factors do what?
increase bon marrow in cancer pts.
steps of HIV (abf)
attachment, binding, and fusion
stage 1 is
local
stage 2
early advanced local
stage 3
late adavanced local
TNM
T – primary Tumor size
N – location and number of Positive lymph node
M – distant Metastasis
cancer prevention - primary, secondar, tert.
primary - Avoid carcinogen exposure and promote health
secondary - Early detection and treatment
tertiary - Monitoring for or preventing recurrence of the original cancer
types of biotherapy
Biotherapy: Targeted therapy and Immunotherapy
target therapy usually given in what form
daily pill
common side effects of immunotherapy (I for immunotherapy, I for itis”
itis - inflammation
for allergic reaction
for infection always have a ambu bag and suction**adrenaline and epinephrine (IM not IV) - not Epipen
NNRTI s/e (nrving itch liver)
liver, fever, headaches
how to give fuzeon?
Sub Q
important education for cancer patients?
use help 30 - 60 minutes before treatment. non-fizzy ginger ale, benadryl,e tc.
amantadine - what ages?
no younger than 12 months
gangcylcovir side effect (ganging up on my bones)
bone marrow suppression
zidovudine side effect (z baby is heavy on my bones)
bone marrow suppression
macrolide s/e (glide into hearing loss and palps)
palpitations and hearing loss
tb drug s/e
hearing loss (ototoxicity); nephrotoxicity; seizure activity; altered vision; blindness;
cancer drugs - cytarabine syndrome
cytarabine syndrome. This usually occurs within 6 to 12 hours after drug administration and is char- acterized by fever, muscle and bone pain, maculopapular rash, conjunctivitis, and malaise.
vincristine and tophermase are waht class? (mite you be christy or topher?)
mitotic
vincristine and tophermase s/e (christine and topher kill major organs)
hepatic and renal, measure uric acid
antiandrogens s/e (androgenous with edema)
peripheral edema, which could exacerbate any pre-existing cardiac disorder
alkylating drugs s/e (alkys cause anemia)
anemia, leukopenia, and thrombocytopenia. and monitor for infiltration.
ex. of 1st generation ceph (violin first instrument)
cefazolin (ancef) , keflex
1st gen ceph used for prophylaxis, but also (your 1st gen, you got…)
staph
phases of herpes (herpes PAC)
🞑 Pre-eruptive phase (preherpetic neuralgia)
🞑 Acute eruptive phase
🞑 Chronic phase (PHN)
amantadine - narrow or broad?
narrow
elisa
detects HIV
HIV steps (dump)
circulates, attaches, dumps, RNA to DNA, inserted into cytochrome in integrase. Then DNA activated and new cells come together then budding. New one matures, then cut protease for new assembly.
A to Z is retro
retro (retrovir)
adherence (understand your food, meds, records, and contact person)
🞑 Patient understanding of each medication’s purpose
🞑 Food & fluid restrictions
🞑 Recommended food choices
🞑 Storage of medications
🞑 Appropriate recording sheet
🞑 Contact personf or questions
pep treatment (ralt is tru and has pep)
Raltegravir & Truvada
emtricitabine (Emtriva®) s/e (EMTs have HIV and hyperpigmentation)
hyperigmentation of soles of feet
NNRTIs are
non-competitive
NRTIS
dealsz
protease inhibitors ex (Rey teases the kale)
Lopinavir/ritonavir (Kaletra®), atazanavir (Reyataz®),
NRTI ex.
azt
